- 學位論文
以近紅外光譜儀量測系統評估周邊動脈疾病治療效果
Evaluate the Treatment Effect of Peripheral Arterial Occlusion Disease with Near-infrared Spectrometer Measurement System
摘要
目的：開發一近紅外光譜儀(NIRS)量測系統來評估周邊動脈阻塞疾病(PAD)。此系統以無線的方式在PAD病人進行復健運動時測量。 方法：將波長分別為 740nm、808nm 和 850nm 的兩組近紅外(NIR)發光二極體(LED) 發射光源模組放置在距離光接收器 32 mm 與40 mm 的位置，兩個光源與光接收器在同一直線上，兩光源距離8mm，同時量測肌肉組織深層的散射吸收光譜。使用修正的比爾定理提取組織飽合氧濃度，並自製組織液態假體對自製的NIRS量測系統進行數值驗證。利用靜態實驗與動態實驗對自製的NIRS量測系統進行驗證，同時找尋在運動中NIRS量測組織氧代謝的穩定變化參數。收取13位基隆長庚PAD病人的4個下肢肌肉組織在運動復健時的組織氧代謝情況進行評估。 結果與討論：在NIRS系統測試中，發現運動完後最大的組織飽和氧濃(StO2%)與恢復於起始StO2%的時間可以做為不同次運動的比較參數。自製的NIRS量測數值對於組織液態假體呈現一至的變化，並且分別得到StO2%、ΔO2Hb與ΔHb三條相關性都為0.99以上的校正曲線。在評估PAD運動復健上，以運動過程中ΔO2Hb是否增加做為達到復健目標做為評估標準，共52個部位中只有27%的組織達到復健需求，以人為單位，有70%達到復健需求，顯示PAD是複雜的疾病。 結論：自製的NIRS系統有助於檢測運動過程中的組織氧代謝變化。此裝置可以提供醫師對於PAD病人進行精準運動復健處方的制定。
並列摘要
Purpose: A near-infrared spectroscopy system (NIRS) was developed to evaluate peripheral arterial occlusion disease (PAD). The wireless device can take measurements when patients are doing rehabilitation exercise. Methods: Two modules of near-infrared (NIR) light-emitting diode (LED) light sources with wavelengths of 740 nm, 808 nm and 850 nm were placed at 32 mm and 40mm from the photodiode. Two NIR LED modules and one photodiode is on the same straight line, the distance between the two LED modules is 8mm, and the deep scattering absorption spectrum of the muscle tissue is detected. The modified Beer-Lambert law was used to extract the tissue oxygen saturation, and the self-made tissue liquid phantom was used to numerical verification of the self-made NIRS system. The self-made NIRS device was systematically verified by static and dynamic experiments, and the stable parameters of NIRS in measuring tissue oxygen saturation during exercise were searched. The tissue oxygen metabolism of 4 lower limbs muscle tissues of 13 Keelung Chang Gung PAD patients during rehabilitation exercise was evaluated. Results and Discussion: In NIRS system moving test, it was found that the maximum tissue oxygen saturation (StO2%) after exercise and the time at the initial StO2% during recovery could be used as comparison parameters for different exercises. The measurement value by the self-made NIRS showed same change pattern for the tissue liquid phantom. Three calibration curves with StO2%, ΔO2Hb and ΔHb correlations above 0.99 were obtained. In the evaluation of PAD rehabilitation exercise, increasing ΔO2Hb during exercise is used as the evaluation standard to achieve the rehabilitation goal. The results show that 27% of the 52 parts patient’s muscle and 70% of patients meet the rehabilitation needs. The results of NIRS rehabilitation exercise evaluation shows that PAD is a complex disease. Conclusion: A self-made NIRS system can detect tissue oxygen metabolism during exercise. This device can provide doctors with the formulation of precise rehabilitation exercise prescriptions for PAD patients in the future.